Isolated fallopian tube torsion in pediatric and adolescent females: a retrospective review of 15 cases at a single institution.

STUDY
OBJECTIVE: To identify and review cases of isolated fallopian tube torsion (FTT) at our institution to further characterize diagnosis and management.
DESIGN: Retrospective review.
SETTING: Tertiary care medical center. PARTICIPANTS: Case series of pediatric and adolescent females, <21 years old, with operatively diagnosed isolated fallopian tube torsion from our institution. INTERVENTION: None. MAIN OUTCOME MEASURE: Isolated fallopian tube torsion.
RESULTS: Fifteen cases of isolated fallopian tube torsion were identified based on intraoperative diagnosis. Patient ages ranged from 8-15 years old, mean age of 12. Fourteen patients (93%) presented with abdominal pain, 8 (53%) localized to the side of associated torsion. Ultrasonography reports described a tubular structure in 4 patients and an associated ovarian or paraovarian cyst in eleven patients. Suspicion of fallopian tube torsion was only described for those patients with a tubular structure described on ultrasonography report. Intraoperatively, 7 patients (47%) were found to have no associated pathology and 8 (53%) were found to have associated cyst or hydrosalpinx. Eight (53%) patients underwent salipingectomy and 7 (47%) underwent reversal of torsion with drainage of associated cyst or cystectomy.
CONCLUSIONS: Isolated fallopian tube torsion is a rare condition that seems to occur in younger adolescents. Vague clinical presentation contributes to low preoperative suspicion. Preoperative suspicion may be increased based on radiographic findings of an enlarged tubular structure or an adjacent normal ovary. Management may be considered nonemergent and salpingectomy is controversial. Long-term fertility outcomes must be further assessed for more definitive decisions regarding surgical management.